The Training Page: NIH Academy

The NIH Academy on Health Disparities: Improving Health Equity

BY JALEN BROWN, NCI

Recent events have widened our understanding of health disparities and the social determinants of health that exacerbate them. The COVID-19 pandemic has put a spotlight on health disparities: The pandemic has adversely affected many disadvantaged populations, putting them at greater risk of infection, hospitalization, and death. These populations include, but are not limited to, racial and ethnic minorities, socioeconomically disadvantaged groups, underserved rural populations, and sexual and gender minorities (people in the LGBTQ+ community).

The NIH Academy on Health Disparities offers postbac trainees the opportunity to learn about health disparities and investigate what is being done to address them. I joined the program myself in 2021 because I wanted to pursue a career in this field and increase my knowledge of the kinds of marginalized communities that exist.

The NIH Academy began with just 10 students in 2000 to train future researchers, physicians, physician–scientists, and other health care workers to lead change in addressing health disparities. The students each investigated health-disparity topics with an academic preceptor, volunteered their time and service to marginalized communities, and submitted summaries about their learning experiences.

“Around 2010, I started thinking about a model that would allow more postbacs to join,” said Sharon Milgram, director of the Office of Intramural Training and Education (OITE). “I set a goal that I wanted 10 times the number of postbacs to learn about health disparities.” The program has grown considerably since then—the 2021–2022 cohort included 210 trainees.

One way that OITE increased the number of postbacs in the program was to collaborate with various institutes and centers (ICs) and invite NIH Academy members to attend IC-hosted lectures and seminars on a variety of health-disparity topics. Postbacs then participated in speaker-led discussions as a community.

Each NIH Academy member must fulfill criteria that include attending lectures, seminars, panels, and discussions; completing an OITE diversity course; and developing and presenting a health-disparity-centered project. Milgram also expects that, after the COVID-19 pandemic, volunteering in communities affected by health disparities will return as a requirement.

My group, comprising seven individuals, centered our proposal on mandating the reporting of the number of sexual and gender minorities in NIH clinical trials and providing competency trainings to researchers on LGBTQ+ health. We explained how our proposal would help to reduce researcher prejudice and discrimination against people in the LGBTQ+ community and build inclusive clinical trials with LGBTQ+ people. We presented our ideas to the Sexual and Gender Minority Research Office at NIH. The experience has allowed me to connect with like-minded postbacs across the ICs and understand their passions for work in health disparities.

“We talk to many participants who say the Academy was a formative experience,” said Milgram. “I think the Academy has helped people shape their applications and helped diverse individuals get into good [graduate and medical school] programs.”

Tracking long-term outcomes for NIH Academy alumni is an important next step. “We have some serious work to evaluate outcomes from the program,” said Milgram. “We want to know if this experience influenced career decision-making. We also want to understand how participation in our five-week diversity course, which can be challenging for participants, makes you more likely to lean into the beauty of diversity instead of the discomfort of the discussions.”

Growing the next generation of health-equity researchers has become even more important today. “I think being aware of health disparities no matter what career path you choose is very important,” said Andrea Naranjo Erazo, who has been one of the co-directors of the NIH Academy since 2021. “You can contribute in multiple ways.”

Thanks to the NIH Academy program, my interest in health disparities has grown considerably. In particular, I have developed new research interests for investigating sexual and gender minority populations. When I enter medical school this year, I will be more prepared to participate in discussions of health equity that require forward-thinking on better treatment of minoritized communities and the dismantling of systemic barriers to accessing health care.

Applications for the next cycle of the NIH Academy on Health Disparities will open in August 2022. “The main component we look for is a letter of interest indicating a strong desire to learn about health disparities,” said Naranjo Erazo. Applicants will also need approval from their mentor.

For more information, go to https://www.training.nih.gov/programs/academy.

Jalen Brown, a postbac in the National Cancer Institute’s Division of Cancer Epidemiology and Genetics, is investigating health disparities affecting sexual and gender minority populations. Later this year, Jalen will begin pursuing an M.D./M.P.H. degree at Northwestern University’s Feinberg School of Medicine (Chicago). Outside of work, Jalen enjoys karaoke, spending time with loved ones, reading, cooking, and making TikTok videos.